Ms. Brown-Woofter opened the discussion with a review of the current state of affairs, a few references to the past and some sobering statistics. She reminded us that the state has a $20B budget with 56% federal and 44% state via the matching program. (see Studies: Medicaid). She went on to describe an explosion in utilization of Medicaid services due to a bad economy. "This is what is driving the interest in managed care," she stated.

Dr. Luna stated that "This is Medicaid managed care 2.0" since it's already been attempted in the past. He was optimistic about the potential to be "ahead of the curve" in Florida. He went to suggest that the Medicaid managed care model works better in densely populated areas as a more robust network can be created.

Mr. Rico was also upbeat. He predicted that managed care would create disciplines that are financially sustainable. He pointed out that there are 3 million Medicaid recipients currently. That number is expected to swell to 4 million by 2014.

Providing proof that panel discussions should always include a fourth, Mr. Rogers weighed in with a few zingers. For example, he stated "Medicaid recipients know how to work the system." He suggested that a program created as temporary assistance to those in an episodic crisis has evolved into a permanent health plan for many citizens. He was decidedly skeptical about the merits of Medicaid managed care stating "You are dealing with a population not receptive to managed care". He went on to impersonate a typical Medicaid patient: "I call the ambulance. They take me to the hospital. That's my health plan."

At the end there was a Q & A. One advocate expressed concern with the potential bad behavior of contracted third parties. Ms. Brown-Woofter assured her that "intense monitoring of managed care" is part of the plan going forward.